title: Comparable seizure characteristics in magnetic seizure therapy and electroconvulsive therapy for major depression.
abstract: Electroconvulsive therapy (ECT) is highly effective for treatment-resistant depression (TRD); however, its use for less severe forms of depression is somewhat limited by a lack of control over current spreading to medial temporal lobe memory structures, resulting in various cognitive side effects. In contrast, magnetic seizure therapy (MST), which uses high frequency repetitive transcranial magnetic stimulation (rTMS) for local seizure induction, has been associated with reduced cognitive side effects. To assess whether different characteristics of seizures induced by both methods are responsible for the differences in neuropsychological side-effect profile, we studied seven TRD-patients undergoing both MST and ECT in an open-label, within subject, controlled crossover pilot study. Comparison parameters included seizure-related ictal characteristics, including motor activity, electromyogram (EMG), electroencephalogram (EEG), and postictal recovery and reorientation times.Our results showed no differences in motor activity or EMG and EEG characteristics, thus implicating similar electrophysiological processes in seizure induction with MST and ECT. In line with previous studies, we observed shorter postictal recovery and reorientation times following MST.The ictal characteristics of induced seizures were found similar with ECT and MST suggesting that the more focal seizure induction associated with MST may account for the more beneficial neuropsychological side effect profile of MST.
authors.affiliation: Department of Psychiatry and Psychotherapy, University Hospital, Bonn, Germany.
authors.forename: Sarah
authors.initials: S
authors.lastname: Kayser
authors.forename: Bettina H
authors.initials: BH
authors.lastname: Bewernick
authors.forename: René
authors.initials: R
authors.lastname: Hurlemann
authors.forename: Martin
authors.initials: M
authors.lastname: Soehle
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Schlaepfer
mesh_terms: D000328:Adult; D018592:Cross-Over Studies; D061218:Depressive Disorder, Treatment-Resistant / Q000503:physiopathology* / Q000628:therapy*; D004565:Electroconvulsive Therapy / Q000009:adverse effects*; D004569:Electroencephalography; D004576:Electromyography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D010865:Pilot Projects; D020127:Recovery of Function; D012640:Seizures / Q000209:etiology* / Q000503:physiopathology*; D013997:Time Factors; D050781:Transcranial Magnetic Stimulation / Q000009:adverse effects*
keywords: Electroconvulsive therapy; Electroencephalogram; Ictal characteristics; Magnetic seizure therapy; Treatment-resistant depression